| Sgoh Acquisition Inc | |
|
346 N Main St Decatur AR 72722-9732 | |
| (479) 752-3233 | |
| (479) 752-3235 |
| Full Name | Sgoh Acquisition Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 346 N Main St, Decatur, Arkansas |
| Authorized Official Name and Position | Paul G Taylor (CEO) |
| Authorized Official Contact | 4178374004 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sgoh Acquisition Inc 346 N Main St Decatur AR 72722-9732 Ph: (479) 752-3233 | Sgoh Acquisition Inc 346 N Main St Decatur AR 72722-9732 Ph: (479) 752-3233 |
| NPI Number | 1699513507 |
|---|---|
| Provider Enumeration Date | 07/16/2024 |
| Last Update Date | 02/20/2025 |
| Medicare PECOS PAC ID | 5092616276 |
|---|---|
| Medicare Enrollment ID | O20241220000144 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699513507 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Spavinaw Clinics, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 346 N. Main Street, Decatur, AR 72722 Phone: 479-752-3232 Fax: 479-752-3235 |